Expressing and Storing Breastmilk For Healthy, Full Term Babies

Expressing and
Storing Breastmilk
For Healthy, Full Term Babies
Expressing and Storing Breastmilk
Table of Contents
Introduction
4
Step 1: How to Clean Containers for Breastmilk Storage
5
Step 2: Getting Ready to Hand Express or Pump
6
Massage Methods
7
Step 3: Expressing Your Breastmilk
8
Step 4: Breastmilk Storage
12
Step 5: Warming and Serving Breastmilk
13
References
14
KFL&A Public Health
Introduction
Giving your baby only breastmilk until he is six months
of age helps to protect him from allergies and certain
diseases.
Expressing and storing milk allows your baby to have
breastmilk when you are separated from him. Many
mothers like to have a small supply of breastmilk in
the freezer for emergencies. It is best to start pumping
when breastfeeding is going well because you will
have established a good milk supply and your baby will
know how to latch well onto your breast. On average,
this takes about 4 weeks. The method of expressing
depends on your preference, and may depend on the
situation. You may express breastmilk by hand or with
a pump.
If you have
questions about pumping,
call Child & Babytalk at
613-549-1154 or
1-800-267-7875,
ext.1555 for more
information.
4
Expressing and Storing Breastmilk
Step 1
How to Clean Containers for
Breastmilk Storage
•Use containers such as baby food jars, mason jars,
glass baby bottles or polyethylene bags designed
for milk storage.
• Always start by washing your hands with soap and
water for at least 15 seconds. Rinse and dry them
with clean paper towels.
• Wash the jars, bottles, and lids. Also wash any part
of the breast pump that will touch your milk. Use hot
soapy water and a brush. Rinse under hot running
water.
•Place on a clean paper towel or tea towel and allow
to air dry.
Babies who are
sick or premature need to
be protected from harmful
bacteria.
Sterilized containers are
provided in the
hospital.
KFL&A Public Health
5
Step 2
Getting Ready to Hand Express or Pump
•Many mothers find it best to express breastmilk when
their breasts feel the fullest, in the morning or about
an hour after feeding.
•Sit somewhere warm and comfortable, and allow
yourself time to relax.
•Think about your baby and if possible, have him
close to you. If you are away from your baby, having
a photo, a tape recording of his voice, or a piece of
his clothing to feel or smell may help.
•Apply either moist or dry heat to your breasts by
taking a bath or shower, using a heating pad set on
low, or applying a warm, wet washcloth or disposable
diaper.
•Gently massage your breasts using one of the
methods shown on page 7.
•Rub the nipples with the palm of your hand held flat,
or gently roll the nipples between your fingers and
thumb. This helps to get a let-down.
6
Expressing and Storing Breastmilk
Massage Methods
Try a variety of methods to find one that works best for you.
Finger tip massage:
•use two fingers,
•press fingertips lightly onto breast,
•make small circles,
•start from the back and move
towards the areola,
•cover your whole breast, and
•massage firmly, but gently.
Diamond hand position:
•support your breast with both hands,
thumbs on top, fingers below, and
•press gently as you move towards
the nipple.
Parallel hand position:
•place one hand above, one below,
•gently press towards your nipple,
and
•rotate your hands as they move
forward.
Warm washcloth massage:
•wet washcloth with warm water, and
•press firmly on your breast, from
back to nipple.
KFL&A Public Health
7
Step 3
Expressing Your Breastmilk
A. Hand Expressing
Hand expressing is more like breastfeeding than
pumping. When you use a pump, you draw the milk out
of your breast. When you hand express, you compress
the milk ducts, which is what your baby does while
breastfeeding. It often takes some practice to get milk
out at first, so be patient with yourself. Some women
find hand expressing better than other methods.
It is also cheapest, because it requires no special
equipment.
Remember that the milk must be gently squeezed from
the milk ducts behind the nipple.
Try this method for hand expressing:
•Hold a wide mouthed clean container under your
nipple, or place the container on a table in front of
you.
•Position your thumb on top and first two fingers under
the areola, a few centimetres behind the nipple.
8
Expressing and Storing Breastmilk
Push to chest wall
Roll
Finish roll
•Press straight in toward your chest wall about 1 inch.
•Roll your thumb and fingers toward the areola. Roll as if you were making
a finger print. This action compresses and empties the milk reservoirs
without damaging sensitive breast tissue.
•Repeat rhythmically and collect the milk.
When the stream of milk slows, vary the position of your hand. Rotate
around the areola to reach more milk ducts. Change hands and repeat.
After 5 to 7 minutes, change breasts. Massage (see pg. 7), stroke, and
shake your breasts. Express again for 3 to 5 minutes at each breast.
Repeat once more. The whole procedure can take about 30 minutes.
Shake
Massage
Stroke
KFL&A Public Health
9
Step 3
Expressing Your Breastmilk
B. Using a Breast Pump
•There are two kinds of breast pumps; hand operated
(manual) pumps, and electric pumps. Many of the
electric pumps recommended on our website (www.
kflapublichealth.ca) also convert to battery operated.
Electric pumps can pump one breast (single pump) or
both breasts at the same time (double pump). Follow
the pump directions on how to use and clean it.
•A double electric pump stimulates your milk supply
better than a single electric pump, and saves time.
•When using a pump, make sure your whole nipple
area fits inside the funnel so it won’t hurt. Start the
pump on the low setting and increase the pressure
as your milk starts to flow. This should not hurt.
•Pumps can be purchased or rented. Call Child &
Babytalk Phone Line at 613-549-1154 for more
information.
10
Expressing and Storing Breastmilk
Tips When Hand Expressing or Pumping
•Massaging your breast while you are pumping or
expressing can help collect more milk.
•It may be helpful to breastfeed on one side while you
express or pump the other side.
•Express from each breast for about 5 minutes, then
go back and repeat on each breast again.
•You may have several letdowns while expressing.
Taking a break between letdowns to relax, massage,
and shake your breasts (see page 9) will help to get
the milk flowing and empty your breasts.
If your baby is sick,
premature, or cannot feed at
the breast, you may need to
use an electric pump.
KFL&A Public Health
11
Step 4
Breastmilk Storage
Where to Store
Longest Storage Time
At room temperature
6 to 8 hours
In a cooler with a freezer pack
1 day
Fresh milk in refrigerator
8 days
Thawed milk in refrigerator
1 day
In a freezer that is inside a refrigerator
2 weeks
In a refrigerator freezer with a separate door
3 to 6 months
In a deep freezer
6 to 12 months
•Breastmilk that is in a clean, tightly sealed container needs to be
refrigerated within 6 to 8 hours. Refrigerate immediately if the
room temperature is over 25º C.
•Store breastmilk in the amount that your baby is likely to need at
one feeding (i.e. 60ml to 120ml quantities) to eliminate waste.
•Cooled breastmilk may be added to already frozen breastmilk if
there is more frozen milk than fresh milk.
•When freezing breastmilk, leave an inch of space in the container.
Breastmilk expands when it is frozen and may crack the
containers.
•Store breastmilk at the back of the fridge or freezer where it will
stay the coldest. Do not store it on the door of the fridge as it will
not be cold enough. If you have a self-defrosting freezer place the
milk on a shelf, because the bottom of the freezer warms up when
it is defrosting.
•Transport breastmilk in an insulated container with ice packs.
•Date the stored breastmilk and use in the order it was dated.
•Once the frozen breastmilk is thawed, it can be kept refrigerated,
as long as it was not offered to the baby. It can be kept for 24
hours in the refrigerator. Never refreeze breastmilk.
12
Expressing and Storing Breastmilk
Step 5
Warming and Serving Breastmilk
•Whenever possible, use fresh breastmilk. It is better
for baby than frozen milk, but frozen milk is the
second best choice.
•Frozen breastmilk can be thawed in the refrigerator.
This takes approximately 12 hours.
•A quicker way to thaw and warm the milk to body
temperature is to place it under cool, then gradually
warmer running water until the breastmilk is
thawed and warmed to room temperature. Test the
breastmilk on the inside of your wrist before offering
it to your baby.
•Breastmilk separates into layers as it is not
homogenized. Shake gently to mix before feeding.
•Thawed breastmilk may taste or smell different from
fresh breastmilk, but it is still good. The altered taste
and smell is caused by the enzyme lipase that breaks
fat down in the breastmilk. It will not
harm the baby.
•Discard any remaining
breastmilk that was not
used at the feeding.
KFL&A Public Health
Caution:
Do not microwave
breastmilk. This may alter
its nutrients and cause
hot spots which can burn
your baby.
13
14
Expressing and Storing Breastmilk
Breast Pumps
A variety of pumps are available for rent or sale from various businesses in the
community. Call Child & Babytalk Phone Line at 613-549-1154 or 1-800-267-7875,
ext. 1555 or visit www.kflapublichealth.ca and click on Parents and Caregivers, then
Learn About Breastfeeding for more information.
References
Breastfeeding [Internet]. Atlanta: Centers for Disease Control and Prevention. Proper handling and storage of human milk. 2007 May 22; [2 pages]. Available from
http://www.cdc.gov/breastfeeding/recommendations/handling_breastmilk.htm
Breastfeeding [Internet]. Peterborough [ON]: Peterborough County-City Health
Unit. Expressing, storing and feeding your baby breastmilk. 2008 June 23; [4 pages]. Available from http://pcchu.peterborough.on.ca/BF/BF-expressingstoring-breastmilk.html
Jones F, Tully M. Best practice for expressing, storing and handling human milk
in hospitals, homes and child care settings. 2nd ed. Raleigh (NC): Human Milk
Banking Association; 2006.
Mohrbacher N, Stock J. The breastfeeding answer book. 3rd rev. ed. Schaumburg (ILL): La Leche League International; 2003.
Nova Scotia. Health Promotion and Protection. Public Health Services; MacGregor
D. Breastfeeding basics [monograph on the Internet]. Halifax (NS): Department
of Health Promotion and Protection; 2007 [cited 2009 April 7]. Available from: http://www.gov.ns.ca/hpp
Riordan J, editor. Breastfeeding and human lactation. 3rd ed. Toronto: Jones and
Bartlett Publishers; 2005.
Toronto Public Health. Breastfeeding protocols for health care providers. Toronto:
Toronto Public Health; 2007.
Copyright Permissions
Graphics and text on pages 7, 8, and 9 are from Breastfeeding Basics, Nova Scotia
Department of Health Promotion and Protection, 2008. Adapted and reprinted
with written permission from Nova Scotia Department of Health Promotion and
Protection.
221 Portsmouth Ave., Kingston, ON K7K 1V5
613-549-1232 or 1-800-267-7875
www.kflapublichealth.ca
September 2009